WASHINGTON (AP) — Government auditors told a House panel Tuesday that efforts to build four veterans medical centers are taking on average about three years longer to complete than estimated and costing an additional $366 million per project.

Rep. Mike Coffman, R-Colo., said the Veterans Affairs Department’s oversight of major constructions projects doesn’t meet industrial standards and described it as dysfunctional. Coffman, who chairs a House subcommittee, said the construction problems ultimately lead to delayed health care for veterans.

The medical centers that have been delayed are in Las Vegas; Orlando, Fla.; Denver; and New Orleans.

Several factors contributed to the delays. For example, the hospital in Las Vegas was initially planned as an expanded clinic that would also be used by troops at Nellis Air Force Base. However, the VA later determined that local veterans needed their own medical center because of the growing population of veterans in Nevada.

One overriding problem was the VA’s inability to deal with design changes in a timely manner, according to the Government Accountability Office, Congress’ auditing and investigative arm. Most major projects require some design changes as construction occurs, but such changes are supposed to be negotiated and approved in a matter of weeks to avoid delays, the GAO said. The agency found that it was common for the VA to take six months or longer to negotiate the changes.

The GAO recommended that medical equipment specialists be involved early in the design process. Specifications for medical equipment at the Orlando hospital changed several times during construction and at one point forced the VA to suspend construction.

Auditors also acknowledged that some delays and cost overruns could not have been anticipated.

Glenn Haggstrom, who oversees the VA’s Office of Acquisition, Logistics and Construction, said that one of the key reasons that costs went up is that the VA often expanded the scope of the hospitals from original projections, not only increasing the size of those hospitals but the types of services provided.

Republican lawmakers used the GAO report to question bonuses that the department pays its senior executives. Rep. Tim Huelskamp of Kansas asked Haggstrom whether he thought he deserved annual five-figure bonuses in recent years in light of the construction delays and cost overruns. He noted that Haggstrom received bonuses ranging from about $16,000 to about $22,000, and added at one point that he would have docked Haggstrom’s pay.

“Those bonuses were not by my own doing,” Haggstrom replied. “Those were done by my superiors.”